Provider Demographics
NPI:1821357211
Name:NOVINSKI, KRISTY (PHD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:
Last Name:NOVINSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 DECKER DR STE 260
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-2306
Mailing Address - Country:US
Mailing Address - Phone:214-310-0346
Mailing Address - Fax:214-310-0346
Practice Address - Street 1:580 DECKER DR STE 260
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-2306
Practice Address - Country:US
Practice Address - Phone:214-310-0346
Practice Address - Fax:214-310-0346
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36426103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical